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Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature

BACKGROUND: Pancreatic acinar cell carcinoma (PACC) is rare, and its appropriate treatment remains unknown. We aim to explore the characteristics and optimal treatment of it. METHODS: The data on clinicopathologic characteristics, molecular alteration, treatment, and survival of patients diagnosed w...

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Autores principales: Xu, Jian-Ying, Guan, Wen-Long, Lu, Shi-Xun, Wei, Xiao-Li, Shi, Wen-Jie, Ren, Chao, Li, Yu-Hong, Li, Sheng-Ping, Qiu, Miao-Zhen, Wang, Feng-Hua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058357/
https://www.ncbi.nlm.nih.gov/pubmed/35509769
http://dx.doi.org/10.1177/11795549221090186
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author Xu, Jian-Ying
Guan, Wen-Long
Lu, Shi-Xun
Wei, Xiao-Li
Shi, Wen-Jie
Ren, Chao
Li, Yu-Hong
Li, Sheng-Ping
Qiu, Miao-Zhen
Wang, Feng-Hua
author_facet Xu, Jian-Ying
Guan, Wen-Long
Lu, Shi-Xun
Wei, Xiao-Li
Shi, Wen-Jie
Ren, Chao
Li, Yu-Hong
Li, Sheng-Ping
Qiu, Miao-Zhen
Wang, Feng-Hua
author_sort Xu, Jian-Ying
collection PubMed
description BACKGROUND: Pancreatic acinar cell carcinoma (PACC) is rare, and its appropriate treatment remains unknown. We aim to explore the characteristics and optimal treatment of it. METHODS: The data on clinicopathologic characteristics, molecular alteration, treatment, and survival of patients diagnosed with PACC at the Sun Yat-sen University Cancer Center from 2005 to 2020 were collected. The optimal treatment was explored by co-analyzing our results and published literatures. RESULTS: Twenty-two PACC patients were enrolled. Eight of 17 non-metastatic patients received adjuvant chemotherapy. The patients receiving fluoropyrimidine-based regimen (n = 3) had a better median disease-free survival (mDFS) than those with gemcitabine-based regimen (n = 5) (unreached vs 27 months). Eight metastatic patients received first-line chemotherapy. Four patients received second-line chemotherapy. The objective response rate (ORR) of the fluoropyrimidine-based regimen was 85.7% (6/7), much better than that of the gemcitabine-based regimen (0/5). One patient who had responded to the first-line FOLFIRINOX (5-fluorouracil + oxaliplatin + leucovorin + irinotecan) regimen received olaparib as maintenance treatment for 5 months with good tolerance. Thirty-one published literatures, with a total of 86 cases, were included in the co-analysis. The ORR of the first-line fluoropyrimidine-based regimen (n = 47) was higher than that of gemcitabine-based regimen (n = 39) (59.6% vs 15.3%, P < .001). Eight of 11 patients treated with the FOLFIRINOX regimen achieved partial response (PR). CONCLUSIONS: For patients with metastasis, a fluorouracil-based regimen such as FOLFIRINOX may be preferred, and maintenance treatment of poly ADP-ribose polymerase (PARP) inhibitors after effective platinum-containing treatment for breast cancer susceptibility gene (BRCA) mutation patients must be assessed.
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spelling pubmed-90583572022-05-03 Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature Xu, Jian-Ying Guan, Wen-Long Lu, Shi-Xun Wei, Xiao-Li Shi, Wen-Jie Ren, Chao Li, Yu-Hong Li, Sheng-Ping Qiu, Miao-Zhen Wang, Feng-Hua Clin Med Insights Oncol Original Research Article BACKGROUND: Pancreatic acinar cell carcinoma (PACC) is rare, and its appropriate treatment remains unknown. We aim to explore the characteristics and optimal treatment of it. METHODS: The data on clinicopathologic characteristics, molecular alteration, treatment, and survival of patients diagnosed with PACC at the Sun Yat-sen University Cancer Center from 2005 to 2020 were collected. The optimal treatment was explored by co-analyzing our results and published literatures. RESULTS: Twenty-two PACC patients were enrolled. Eight of 17 non-metastatic patients received adjuvant chemotherapy. The patients receiving fluoropyrimidine-based regimen (n = 3) had a better median disease-free survival (mDFS) than those with gemcitabine-based regimen (n = 5) (unreached vs 27 months). Eight metastatic patients received first-line chemotherapy. Four patients received second-line chemotherapy. The objective response rate (ORR) of the fluoropyrimidine-based regimen was 85.7% (6/7), much better than that of the gemcitabine-based regimen (0/5). One patient who had responded to the first-line FOLFIRINOX (5-fluorouracil + oxaliplatin + leucovorin + irinotecan) regimen received olaparib as maintenance treatment for 5 months with good tolerance. Thirty-one published literatures, with a total of 86 cases, were included in the co-analysis. The ORR of the first-line fluoropyrimidine-based regimen (n = 47) was higher than that of gemcitabine-based regimen (n = 39) (59.6% vs 15.3%, P < .001). Eight of 11 patients treated with the FOLFIRINOX regimen achieved partial response (PR). CONCLUSIONS: For patients with metastasis, a fluorouracil-based regimen such as FOLFIRINOX may be preferred, and maintenance treatment of poly ADP-ribose polymerase (PARP) inhibitors after effective platinum-containing treatment for breast cancer susceptibility gene (BRCA) mutation patients must be assessed. SAGE Publications 2022-04-30 /pmc/articles/PMC9058357/ /pubmed/35509769 http://dx.doi.org/10.1177/11795549221090186 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Article
Xu, Jian-Ying
Guan, Wen-Long
Lu, Shi-Xun
Wei, Xiao-Li
Shi, Wen-Jie
Ren, Chao
Li, Yu-Hong
Li, Sheng-Ping
Qiu, Miao-Zhen
Wang, Feng-Hua
Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature
title Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature
title_full Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature
title_fullStr Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature
title_full_unstemmed Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature
title_short Optimizing Chemotherapy of Pancreatic Acinar Cell Carcinoma: Our Experiences and Pooled Analysis of Literature
title_sort optimizing chemotherapy of pancreatic acinar cell carcinoma: our experiences and pooled analysis of literature
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058357/
https://www.ncbi.nlm.nih.gov/pubmed/35509769
http://dx.doi.org/10.1177/11795549221090186
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